Mary Immaculate Hospital
2 Bernardine Dr., Newport News, VA · Bonsecours · · NPI 1427064310
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| 17-hydroxypregnenolone CPT 84143 | $33.60 | $56.00 | not published | 0 |
| 2d tte w or without fol w/con,co HCPCS C8923 | $1,535.40 | $2,559.00 | not published | 0 |
| 3d recon without postprocess indpndt CPT 76376 | $597.00 | $995.00 | not published | 0 |
| 5' nucleotidase - sendout CPT 83915 | $69.60 | $116.00 | not published | 0 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $184.20 | $307.00 | not published | 0 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $7,207.50 | $12,012.50 | not published | 0 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $65.40 | $109.00 | not published | 0 |
| Abd aorta w/runoff s&i CPT 75630 | $2,364.00 | $3,940.00 | not published | 0 |
| Abd/low ext cath 1st CPT 36245 | $2,067.00 | $3,445.00 | not published | 0 |
| Abd/low ext cath 2nd CPT 36246 | $2,095.80 | $3,493.00 | not published | 0 |
| Abd/low ext cath 3rd CPT 36247 | $2,442.00 | $4,070.00 | not published | 0 |
| Abd/low ext cath addl CPT 36248 | $1,092.60 | $1,821.00 | not published | 0 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $3,406.80 | $5,678.00 | not published | 0 |
| Abdominal CT scan (with contrast) CPT 74160 | $2,822.40 | $4,704.00 | not published | 0 |
| Abdominal CT scan (without contrast) CPT 74150 | $1,533.60 | $2,556.00 | not published | 0 |
| Abdominal MRI (with and without contrast) CPT 74183 | $6,756.60 | $11,261.00 | not published | 0 |
| Abdominal MRI (without contrast) CPT 74181 | $4,209.00 | $7,015.00 | not published | 0 |
| Abdominal pad HCPCS L1270 | $346.15 | $576.92 | not published | 0 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,890.60 | $3,151.00 | not published | 0 |
| Abdominal Ultrasound (complete) CPT 76700 | $1,350.60 | $2,251.00 | not published | 0 |
| Abdominal Ultrasound (limited) CPT 76705 | $620.40 | $1,034.00 | not published | 0 |
| Abdominoplasty 15830 CPT 15830 | $36,500.75 | $60,834.58 | $6,478.71 – $6,608.28 | 3 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,447.20 | $2,412.00 | not published | 0 |
| Abduct control hip semi-flex HCPCS L1630 | $882.31 | $1,470.51 | not published | 0 |
| Abduction bar jointed adjust HCPCS L2300 | $1,051.42 | $1,752.36 | not published | 0 |
| Abduction rotation bar shoe HCPCS L3140 | $371.81 | $619.68 | not published | 0 |
| Abduct rotation bar without shoe HCPCS L3150 | $339.99 | $566.65 | not published | 0 |
| Abl1 gene CPT 81170 | $992.40 | $1,654.00 | not published | 0 |
| Ablation cardiac vagal inputs atrium CPT 93799 | $400.20 | $667.00 | not published | 0 |
| Ablation cryo thigh/knee CPT 27599 | $6,977.05 | $11,628.42 | $240.67 – $245.48 | 3 |
| Ablation of upper extremity nerves rf CPT 64999 | $25,335.19 | $42,225.32 | $5,898.53 – $6,016.50 | 3 |
| Acetaminophen level CPT 80143 | $72.00 | $120.00 | not published | 0 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $286.80 | $478.00 | not published | 0 |
| Acetylcholine receptor modulating antibody CPT 86043 | $218.40 | $364.00 | not published | 0 |
| Acetylcholinesterase assay CPT 82013 | $61.80 | $103.00 | not published | 0 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $24.31 | $40.52 | not published | 0 |
| Acetylcysteine non-comp unit HCPCS J7608 | $74.93 | $124.88 | not published | 0 |
| Acne surgery 10040 CPT 10040 | $475.20 | $792.00 | not published | 0 |
| Acute hepatitis panel CPT 80074 | $264.00 | $440.00 | not published | 0 |
| #acylcarnitineprfl CPT 82017 | $162.00 | $270.00 | not published | 0 |
| Adapter b 8 channel 10cm HCPCS C1883 | $17,711.61 | $29,519.35 | not published | 0 |
| Add le poly knee custom kafo HCPCS L2387 | $797.26 | $1,328.77 | not published | 0 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $57.36 | $95.60 | not published | 0 |
| Adh-sendout CPT 84588 | $203.40 | $339.00 | not published | 0 |
| Adj gastric band via subq port CPT 43999 | $4,100.40 | $6,834.00 | $884.93 – $902.63 | 3 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $26,299.39 | $43,832.32 | $2,013.11 – $2,053.37 | 3 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $796.80 | $1,328.00 | not published | 0 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $502.20 | $837.00 | not published | 0 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $95.40 | $159.00 | not published | 0 |
| Administration immunization 1 vaccine CPT 90471 | $60.00 | $100.00 | not published | 0 |
| Administration immunization each additional vaccine CPT 90472 | $63.00 | $105.00 | not published | 0 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $16,517.07 | $27,528.45 | not published | 0 |
| Aep hearing status deter i&r CPT 92651 | $303.00 | $505.00 | not published | 0 |
| _afb id by dna probe rflx ast CPT 87149 | $112.80 | $188.00 | not published | 0 |
| #afb mycobacteria suscep. #1 CPT 87190 | $31.80 | $53.00 | not published | 0 |
| _afb org id by sequencing rflx ast-sendout CPT 87153 | $657.60 | $1,096.00 | not published | 0 |
| Afo molded ankle gauntlet HCPCS L1904 | $1,885.09 | $3,141.81 | not published | 0 |
| Afo molded plas rig ant tib HCPCS L1945 | $4,303.18 | $7,171.96 | not published | 0 |
| Afo molded to patient plasti HCPCS L1940 | $1,799.90 | $2,999.84 | not published | 0 |
| Afo rig ant tib tcf/= custom HCPCS L1932 | $3,726.72 | $6,211.20 | not published | 0 |
| Afo sing bar clasp attach sh HCPCS L1910 | $1,171.25 | $1,952.08 | not published | 0 |
| Afo sing solid stirrup calf HCPCS L1980 | $1,686.28 | $2,810.47 | not published | 0 |
| Afo sing upright with adjust s HCPCS L1920 | $1,715.69 | $2,859.49 | not published | 0 |
| Afo spiral molded to pt plas HCPCS L1950 | $3,211.88 | $5,353.13 | not published | 0 |
| Afo sprng wir drsflx calf bd HCPCS L1900 | $1,191.53 | $1,985.89 | not published | 0 |
| Afo supramalleolar custom HCPCS L1907 | $2,350.09 | $3,916.82 | not published | 0 |
| Afo tib fx cast plaster mold HCPCS L2106 | $3,291.87 | $5,486.45 | not published | 0 |
| Afo tibial fracture rigid HCPCS L2116 | $3,218.96 | $5,364.94 | not published | 0 |
| Afo tibial fracture soft HCPCS L2112 | $2,107.00 | $3,511.67 | not published | 0 |
| Afo, walk boot type, cus fab HCPCS L4631 | $6,627.28 | $11,045.47 | not published | 0 |
| Afo w/ankle joint, prefab HCPCS L1971 | $2,668.03 | $4,446.72 | not published | 0 |
| After cataract laser surgery CPT 66821 | $2,672.93 | $4,454.88 | $536.62 – $547.36 | 3 |
| Ak/knee disartic pelvic band HCPCS L5697 | $327.53 | $545.88 | not published | 0 |
| Ak/knee disartic silesian ba HCPCS L5698 | $407.34 | $678.90 | not published | 0 |
| Ak sleeve susp neoprene/equa HCPCS L5695 | $737.92 | $1,229.87 | not published | 0 |
| Albumin body fluid quantitative each specimen CPT 82042 | $68.40 | $114.00 | not published | 0 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $501.90 | $836.50 | not published | 0 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $527.00 | $878.33 | not published | 0 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $73.80 | $123.00 | not published | 0 |
| Albumin serum plasma or whole blood CPT 82040 | $64.80 | $108.00 | not published | 0 |
| Albuterol ipratrop non-comp HCPCS J7620 | $10.20 | $17.00 | not published | 0 |
| Albuterol non-comp unit HCPCS J7613 | $10.20 | $17.00 | not published | 0 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $67.20 | $112.00 | not published | 0 |
| Alkaline phosphatase CPT 84075 | $55.80 | $93.00 | not published | 0 |
| Allergen alpha lactalbumin ige CPT 86008 | $60.60 | $101.00 | not published | 0 |
| Allergen egg white ige CPT 86003 | $41.40 | $69.00 | not published | 0 |
| Allograft 160mg placental salera mini membrane HCPCS Q4168 | $11,669.40 | $19,449.00 | not published | 0 |
| Allograft allowrap 4x4cm dry 16sqcm HCPCS Q4150 | $23,011.78 | $38,352.96 | not published | 0 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | $28,875.56 | $48,125.94 | not published | 0 |
| Allograft dermis 20x25x1mm decell w/matracell arthroflex HCPCS Q4125 | $17,958.26 | $29,930.44 | not published | 0 |
| Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm HCPCS Q4128 | $81,521.72 | $135,869.53 | not published | 0 |
| Allograft epieffect 2x3cm-q4186-cost per sq cm HCPCS Q4186 | $54,729.40 | $91,215.66 | not published | 0 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $46,315.37 | $77,192.28 | not published | 0 |
| Allograft membrn amnio 1x2cm hu ambriodry HCPCS V2790 | $43,730.71 | $72,884.52 | not published | 0 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $14,336.04 | $23,893.40 | not published | 0 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $16,374.12 | $27,290.20 | not published | 0 |
| Alpha-fetoprotein afp-l3 frac & total CPT 82107 | $330.60 | $551.00 | not published | 0 |
| Alpha-fetoprotein amniotic CPT 82106 | $104.40 | $174.00 | not published | 0 |
| Alpha-fetoprotein tumor marker CPT 82105 | $134.40 | $224.00 | not published | 0 |
| Alprostadil for injection HCPCS J0270 | $1,214.17 | $2,023.62 | not published | 0 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.